Peer engagement PrinciPles and Best Practices

1 peer engagement PrinciPles and best Practices A guide for BC Health Authorities and other providers This guide was developed by the peer engagement and Evaluation Project Team through a research project funded by Peter Wall Institute for Advanced Studies April 2017..com peer engagement best Practices | April 2017. Acknowledgements peer engagement and Evaluation Project Team: Alissa Greer (BCCDC; University of British Columbia). Ashraf Amlani (BCCDC). Cheri Newman (BCCDC; Fraser Health). Charlene Burmeister (BCCDC; Northern Health). Brian Leblanc (BCCDC; Interior Health). Katie Lacroix (BCCDC; Island Health). Hugh Lampkin (BCCDC; Vancouver Coastal Health). Erin Gibson (Fraser Health). Jeff Walsh (Interior Health). Alex Scott (Vancouver Coastal Health).

2 Dr. Bernadette Pauly (University of Victoria). Dr. Jane Buxton (PI) (BCCDC; University of British Columbia). Special thanks to: Emily Ogborne-Hill, Sonya Ishiguro, Margot Kuo, Heather Burgess, Lauren Mathany, Sara Young, Jessica Bridgeman, Kate Fish, Griffin Russell, Camille Drexl, Florence Ranville, James Tigchelaar, Janine Stevenson, Dr. Kenneth Tupper, Kathleen Perkins, Reanne Sanford, Jonathan Spence, and all the staff and clients at participating community focus group sites. Contact information BC Centre for Disease Control Harm Reduction Program 655 West 12th Avenue Vancouver BC V5Z 4R4. Email: Original Date of Publication: October 15, 2016. Revised Edition: April 1, 2017. Report is available at Suggested citation Greer, , Amlani, , Buxton, & the PEEP team.

3 (2017). peer engagement best Practices : A Guide for Health Authorities and other providers. Vancouver, BC: BC Centre for Disease Control. peer engagement best Practices | April 2017. EXECUTIVE SUMMARY. Introduction peer engagement can be defined as the active participation of people with lived experience of substance use in research, program, and policy decision-making processes. Peers can provide insights into the realities of substance use and their local risk environments, and the applicability of programs and policies. peer engagement can be mutually beneficial in promoting health equity in programs and policies while building capacity for peers and Health Authority representatives. Context for this report The BC Harm Reduction Strategies and Services Committee (BCHRSS) is committed to engaging peers to ensure harm reduction services across the province are equitable and meeting the needs of people who use substances.

4 Over the past decade or so, peer engagement has been an evolving, iterative process. Although peer engagement has improved, there remains is often a lack of understanding of peer engagement PrinciPles and Practices among Health Authorities. From this identified gap, the peer engagement and Evaluation Project (PEEP) was initiated. PEEP is a research project that builds on BCHRSS experiences and existing relationships with peers. This project aims to enhance peer engagement and voices that have been missing from decision-making tables across the province through the development, implementation, and evaluation of best Practices guidelines for BC Health Authorities. PEEP Methods PEEP is participatory in that it engaged five peer research assistants and several Health Authority representatives from across the province as active members of the research team throughout the project.

5 In 2015, the PEEP team conducted 13 focus groups with 83 participants across all five regional Health Authorities. The qualitative data was coded by PEEP team members peer engagement best Practices | April 2017. and themes were derived through a participatory process. The final four broad themes were societal and community readiness, peer networks, peer engagement , and stigma and trust. These themes, along with the experience our own team has had in engaging peers, and review of the literature have informed the focus and content of the peer engagement PrinciPles and best practice guidelines for BC Health Authorities. peer engagement PrinciPles The PrinciPles outlined in this report provide justification and support for enhancing peer engagement among BC Health Authorities and include the definition and importance of peer engagement , consideration of power dynamics, benefits to peer and providers, regional differences, stigma and trust, organizational support, and independent networks of peers.

6 peer engagement best Practices peer engagement Practices are not limited to one-on-one participation processes; they include certain considerations in the preparation, engagement , support, and conclusion stages of peer engagement . This document provides both an overview and details of these processes to support meaningful and equitable engagement between Health Authority representatives and peers. Conclusion Promoting peer engagement within Health Authorities can improve the involvement and uptake of peers' voices in health service planning and policy making in BC. Individuals who work in Health Authorities can use these peer engagement PrinciPles and best practice guidelines to foster meaningful engagement , which can in turn promote positive relationship and capacity building for everyone involved.

7 peer engagement best Practices | April 2017. Table of Contents Glossary of Abbreviations.. 1. Background.. 2. peer engagement and Evaluation Project .. 2. (PEEP) Rationale.. 2. peep Methods.. 4. peer engagement PrinciPles .. 6. What is peer engagement ?.. 6. The importance of peer engagement .. 7. Sharing the table and power .. 9. The benefits of peer engagement ..10. Regional differences .. 10. Stigma and trust.. 11. Organizational support needed for peer engagement .. 12. peer networks.. 13. peer engagement best Practices .. 14. Overview.. 14. Preparing to Engage.. 16. Start Early.. 16. Equitable participation.. 16. How many peers should I engage with? .. 17. Recruiting peers .. 17. Partnering with peer Run Organizations.

8 18. Setting up compensation .. 19. Setting expectations with peers and providers.. 20. Expectations of peers .. 20. Expectations of providers.. 22. Expectations of the team.. 23. Developing a memorandum of understanding.. 23. Defining objectives for engagement .. 25. peer engagement best Practices | April 2017. Engaging peers.. 26. Do's and Don'ts .. 26. Overcoming barriers.. 28. Childcare .. 28. Literacy and communication .. 29. Substance use .. 30. Location.. 31. Travel.. 31. Setting ground rules for meetings.. 32. Building a work plan .. 34. Supports .. 35. Healthy boundaries for Health Authority providers .. 35. Setting up supports for staff.. 36. Setting up supports for peers.. 37. Mental/emotional support.. 37.

9 Substance use support.. 37. Financial planning support.. 38. peer mentors and navigators.. 38. Wrapping up .. 39. Disseminating knowledge.. 39. Avoiding sense of loss at completion .. 40. Evaluation .. 41. References.. 42. Appendix 1: List of peer Run Organizations in British Columbia.. 45. peer engagement best Practices | April 2017. Glossary of Abbreviations BC: British Columbia BCCDC: British Columbia Centre for Disease Control BCHRSS: British Columbia Harm Reduction Strategies and Services IAP2: International Association for Public Participation MoU: Memorandum of understanding OST: Opioid Substitution Therapy PRA: peer research assistant PEEP: peer engagement and Evaluation Project PWUD: People who use drugs SOLID: Society of Living Illicit Drug Users VANDU: Vancouver Area Network of Drug Users 1.

10 peer engagement best Practices | April 2017. Background peer engagement and Evaluation Project (PEEP) Rationale People who use illegal drugs, or peers', are more likely to contract HIV and hepatitis C virus, to experience mental illness and physical morbidities, and to die prematurely (1). Harm reduction programs are supported provincially, nationally, and internationally to reduce the transmission of blood-borne viruses and infections, promote safer drug use and sexual behaviors, increase access to healthcare and other supports, and prevent and reverse overdoses (2,3). However, simply making harm reduction supplies available is not sufficient (4). A recent survey of harm reduction clients in British Columbia (BC) revealed that patterns of drug use and the types of harm reduction services available vary considerably across the province (5).